What is Prolapse of the Umbilical Cord

Prolapse of the umbilical cord is a problem that can happen during labor if the umbilical cord enters the birth canal before the baby.

This condition is a medical emergency. If the baby puts pressure on the cord, blood and oxygen may not be able to reach the baby’s brain. The result may be brain damage or even death of the baby.

What are the causes?

This condition may be caused by:

• Water breaking before labor starts (premature rupture of the membranes).
• Water breaking before the baby’s head or bottom is in the birth canal.
• Water breaking followed by a very large gush of fluid.

What increases the risk?

This condition is more likely to develop if:

• The umbilical cord is too long.
• The baby is premature.
• The mother is carrying multiple babies.
• There is too much amniotic fluid.
• The baby is in an abnormal position, such as:
  • Bottom or feet first (breech position).
  • Lying sideways (transverse position).
  • Lying in a slant position (oblique position).

What are the signs or symptoms?

The main symptom of this condition is noticing the umbilical cord coming down the vagina during labor.

How is this diagnosed?

This condition may be diagnosed when a health care provider:

• Feels the umbilical cord inside the vagina or sees it coming out of the vagina.
• Checks the baby’s heart rate and finds that it is abnormal.

How is this treated?

This condition is an emergency. Treatment involves:

• Having the mother lie down on her back and propping her hips and butt up with several pillows so that they are higher than her head. This position is called the Trendelenburg position.
• A vaginal exam. During the exam, the baby’s head or butt will be pushed up and away from the cord so they do not put pressure on it.
• Delivering the baby by cesarean delivery as soon as possible.

How is this prevented?

• Have ultrasounds as recommended by your health care provider.
• Follow your health care provider’s advice regarding pregnancy, labor, and delivery.
• Keep all of your prenatal appointments as told by your health care provider. This is important.

Summary

• Prolapse of the umbilical cord is a problem that can happen during labor if the umbilical cord enters the birth canal before the baby.
• This condition is a medical emergency.
• Treatment may include: repositioning the woman, examining the vagina, and delivering the baby as soon as possible.